1403 - The Pediatric Emergency Room as a Promising Setting for Receiving the Flu Shot

Background: Children are the most likely population to get influenza, and are two times more likely compared to adults aged 65 and greater (attack rate by age group: 0-17 yo 9.3%, 18-74 yo 8.8%, 65+ 3.9%). Additionally, children are at high risk of suffering complications from influenza. According to the CDC, the overall effectiveness of the 2018-2019 flu vaccine for both strains A and B was 48% in children aged 6m-8 years and 7% in children aged 9- 17 years. Currently our Pediatric Emergency Department (PED) does not routinely offer influenza vaccine to unvaccinated patients. Our project goals are to identify barriers to the administration of influenza vaccine in the PED and to offer and administer influenza vaccine to eligible patients.
 
 

Methods: After performing root cause analysis with key stakeholders, the first countermeasure implemented in a Plan-Do-Study Act (PDSA) cycle was the development of a screening form including eligibility criteria, history of influenza vaccine, consent for vaccine or reason for declining vaccine. The screening form was administered by resident physicians in our PED from October to November who then went on to order the vaccine for eligible patients who consented. Primary outcome measures included number of patients screened per month, percent of patients who desired the vaccine, and the percent of patients who received the vaccine in the ED during their visit. Secondary outcome measures included length of PED stay.
 

Results: Preliminary results show that 75% (42/56,CI: 62%-86%) of children screened in the PED between October and November were eligible for the influenza vaccine. Of those eligible, 59% (29/42, CI: 43%-74%) received the vaccine. The average length of stay was comparable between those that received influenza vaccine and those that did not (p value 0.4756).
 

Conclusion: A subset of eligible patients are now being offered and receiving the flu shot in our PED. Over half of eligible patients received the influenza vaccine, demonstrating that a resident administered screening form has been a successful countermeasure for increasing vaccine rates. Future PDSA cycles will focus on further increasing the number of patients screened and capturing patients who consented but did not receive vaccine.